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Reliance on Acute Care Settings for Health Care Utilization
Reliance on Acute Care Settings for Health Care Utilization
- Source :
- Pediatr Emerg Care
- Publication Year :
- 2020
- Publisher :
- Ovid Technologies (Wolters Kluwer Health), 2020.
-
Abstract
- OBJECTIVE Because a goal of the Affordable Care Act was to increase preventive care and reduce high-cost care, the objective of this study was to evaluate current health care use and reliance on acute care settings among Medicaid-enrolled children. METHODS This was a retrospective cohort study of the 2015 Truven Marketscan Medicaid claims database among children 0 to 21 years old with at least 11 months of continuous enrollment. We calculated adjusted probabilities of health care use (any health care use and ≥1 health maintenance visit) and high acute care reliance (ratio of emergency department or urgent care visits to all health care visits >0.33) by age and compared use between adolescents and younger children using multivariable logistic regression. RESULTS Of the 5,182,540 Medicaid-enrolled children, 18.9% had no health care visits and 47.3% had 1 or more health maintenance visit in 2015. Both health care use and health maintenance visits decreased with increasing age (P < 0.001). Compared with younger children (0-10 years old), adolescents were more likely to have no interaction with the health care system [adjusted odds ratio (aOR), 2.20; 95% confidence interval (CI), 2.19-2.21] and less likely to have health maintenance visits (aOR, 0.40; 0.39-0.40). High acute care reliance was associated with increasing age, with adolescents having greater odds of high acute care reliance (aOR, 1.08; 1.08-1.09). CONCLUSIONS Medicaid-enrolled adolescents have low rates of health care use and have high reliance on acute care settings. Further investigation into adolescent-specific barriers to health maintenance care and drivers for acute care is warranted.
- Subjects :
- Adult
medicine.medical_specialty
Adolescent
MEDLINE
Logistic regression
Article
Young Adult
03 medical and health sciences
0302 clinical medicine
030225 pediatrics
Acute care
Health care
Ambulatory Care
Humans
Medicine
Child
Retrospective Studies
Medicaid
business.industry
Patient Protection and Affordable Care Act
Infant, Newborn
Infant
030208 emergency & critical care medicine
Retrospective cohort study
General Medicine
Odds ratio
Emergency department
Patient Acceptance of Health Care
United States
Child, Preschool
Family medicine
Pediatrics, Perinatology and Child Health
Emergency Medicine
business
Subjects
Details
- ISSN :
- 15351815 and 07495161
- Volume :
- 37
- Database :
- OpenAIRE
- Journal :
- Pediatric Emergency Care
- Accession number :
- edsair.doi.dedup.....45a1005d461bee9afffdfe748c40bf67
- Full Text :
- https://doi.org/10.1097/pec.0000000000001924